Diagnostics
by Snivellus Tobias Snape
Summary: House is forced into clinic duty, as well as teaching student doctors how to be as loving and compassionate as he is. Or not!
1. Chapter 1

I'm a doctor in a teaching hospital and I'm surrounded by students in pressed white lab coats. I'm wearing my Led Zeppelin concert shirt and jeans, blazing my way through the crowd of about thirty students. They step aside respectfully. I feel like a rock star. Only one woman looks me in the eye, a chick named Savannah Vine, but I bump her aside with my cane and she stumbles back into the crowd.

The students follow behind me like ducklings as I stride along the hall. I start to feel smug and suddenly my cane snaps in half and I collapse to the floor.

I look up at the students. My knee throbs from where I hit it on the floor and blood starts to gush out. Savannah reaches out for my hand and everyone begins to laugh. I'm lying on the floor, covered in blood, and thirty students—no, hundreds now—laugh until their cruel shrieking fills the hall and I shout, "Shut up!"

And that's when I wake up.

Grabbing the glass by my bed, I gulped down some water and pills. My knee throbbed in real life—actually, most of the dream could be real, except for actually hitting the floor.

I got up (twenty minutes before the alarm went off), laughing at the impossibility of my dream. And yet I leaned on my cane and whacked it against the counter before I deemed it safe enough to use.

My proteges were already in the classroom when I walked in. They'd been gabbing about some mundane topic—like what flavor ice cream they liked or how they chewed their food—but the chatter stopped when I walked in. Blessed peace. I had a headache already.

I taught the class on Monday and Friday and took one apprentice to trail around after me, as a bargain with Cuddy to avoid clinic duty as much as possible. My heart skipped a beat when I saw my student, Savannah, but I pretended not to care one way or the other. Ever since the last student rotation, Cuddy got a little testy with me and asked me to keep my trysts to a minimum, by which she meant not at all. As though I actually scored any of the hot studidiots I'd bragged about. But the rumor played to my advantage and kept my colleagues from thinking all I do after work is go home to feed my fish, drink beer, and catch up on Lost episodes.

I started every class by opening old patient files for the students to diagnose. I followed the format I used with my own team, writing symptoms on the board and describing the patient, so that if I ever hired any of them, they'd be used to that process. We discussed brachial plexis neuropathies until the students' eyes began to glaze over, then I sent them to follow their assigned doctor on rounds.

I took Savannah with me and we headed to the clinic. We passed by the wheelchair storage room and I snapped my fingers and said, "Get me a wheelchair."

"Just a regular one?"

"No," I said, squeezing my eyes shut. "Get me a double wide since I clearly weigh four hundred pounds."

When I opened my eyes, a wheelchair sat in front of me like magic.

"Did you sign it out?" I asked, surprised.

She nodded. "I signed your name to it."

"Why? So you can lose your license and go to jail for forgery?"

"Not signed," she said, flustered. She pushed her auburn hair behind her ears. "I meant printed. Beside my name. Since you're my supervisor."

"It's just a wheelchair log," I said, "don't make it such a big deal." I stuck my cane into the spokes and pulled it to face me. "Lock the brakes."

She bent to lock it as my knee gave out. I grabbed the bar to stop myself but my hand slipped and I landed hard in the seat.

"Not fast enough," I said, breathing hard. "Let's go."

Savannah blinked at me, looking slightly defiant. "I didn't know you would plop into it."

I handed her my cane without speaking. I pulled the chart and flipped through it. "Nineteen year old kid, spinal cord injury two months ago."

"My son is nineteen."

I looked her up and down. "You have a nineteen year old? What were you, twelve when you had him?"

She laughed loudly. "No, I was six."

She reached for the door handle and I grabbed her wrist.

"Knock and announce, it's not an option," I said, rapping on the door. "Dr House!"

The kid in the wheelchair gawked at me as I wheeled in. Or maybe he was gawking at my hot student. I sneered at him.

"This is Dr. Vine," I said. "She's going to check you over." I mimed zipping my lips and pointed to her. He sat up a little straighter at that bit of good news.

"Right." She sounded nervous and she stood about five feet away from the patient. "The chart says you sustained a spinal cord injury."

"Tell him something he doesn't know," I said. "Do you have any questions for Dr. Vine, Matthew?"  
"Um..." His face turned red and he looked at me as he spoke. "I, uh...my girlfriend wants to know if we can still, like...do it."

"You haven't done it in two months?" I blurted out. "It's just your legs that don't work."

Savannah looked uncomfortable. She shifted back about five more feet and I placed my hand on her back and pushed her toward the patient.

"Tell us, Dr. Vine," I said, "is Matthew able to do the nasty?"

A long pause followed. It would have been awkward if I hadn't been the one to inflict it.

"You fail," I said to Savannah, wheeling closer to Matthew. "The answer is yes. Trust me, I'm the voice of personal experience."

"You don't have a spinal cord injury," Savannah said, looking as though she wished I would leave.

"No, but I'm an expert on doing it," I said smugly. "So I've been told."

Savannah snorted. Matt looked from me to Savannah like he was watching a tennis match.

"Any other questions?" I said, feeling slightly stung.

We finished the exam and left the room. One patient down and it was time for my coffee break. I wheeled into my office and Savannah followed behind me.

"Coffee?" I reached back and Savannah handed me my cane. I smiled, my back to her. She was either sucking up or she was genuinely that good.

"Sure," she said.

I considered pouring myself a cup and telling her "Help yourself!" but then realized I was trying to do a better job since I made my last student cry, even though Savannah didn't seem like the type I could make cry. I was actually considering hiring her based on that fact alone. I handed her a mug and poured myself another cup.

"Thanks!" Savannah said. She sat down at the table and blew on her coffee. "Hey, can I ask you a question, Dr. H?"

That was another thing to add to my list of why Savannah unnerved me. Everyone else called me House and for some reason she insisted on calling me "Dr H."

"You can ask me anything," I said, feeling suddenly guilty about accidentally locking my last student in the supply closet for three hours. (It's a testimony to our lazy nurses that it took three hours for them to need something out of the closet, but Angela probably could have survived on toothpaste and shampoo caps for a few days if necessary.)

Savannah looked down at her cup and my heart stopped. She wasn't going to ask questions about our last patient.

"Why do you have to use a cane?"

"None of your business," I said sharply.

"Okay," she said, shrugging. "I was just curious. Don't I have the right to ask?"

"I'll tell you what," I said, leaning back in the wheelchair. "I'll let you do an exam on me and you tell me what happened to me. If you're right, you pass."

"I'll fail if I don't diagnose you correctly?"

"Then you won't shoot off too many wrong answers before you research, will you?" I turned around and wheeled to the sink, setting my coffee cup down. "Let's go do an exam."

"Who do we have next?" Savannah asked.

I smirked. "Me."


	2. Chapter 2

Savannah shut the exam room door behind us as I hopped onto the table. She'd asked to pull my chart, but I wanted to let her examine me without any clues.

"So what brings you here?" Savannah asked.

"I was on vacation in Hawaii with my girlfriend. We were eating nachos and playing golf, and I suddenly collapsed with horrible pain in my leg."

"What kind of pain?" Savannah asked, pulling out the little notebook she always kept in her lab coat.

"Shooting, severe, excruciating. Eight out of ten, if you were going to ask." I pointed to the pain scale, which ranged from a smiling face to a tormented face with tears on its cheeks, and stabbed my finger at the face with a twisted expression.

"And how were the nachos?"

"Excruciating," I said.

Savannah smiled. "So what happened after you collapsed in pain?"

"My girlfriend called an ambulance. I puked all over her so she was glad to get rid of me. The doctors diagnosed me immediately, but incorrectly, I might add, in case you were about to shoot off an answer immediately."

"Can I look at your leg?"

I stood and pulled my pants down, turning to the right. "You can look at my left leg."

"Is it your right that hurts?"  
I nodded. "But it would be cheating to look at that leg. I wouldn't want to give you an advantage."

"Of course not." Savannah ran her hand up and down my leg.

"Are you molesting me?"

"I'm trying to diagnose you," Savannah said, sounding slightly annoyed. "But in your world, that's a fine line. What happened after you were diagnosed incorrectly? Did the pain get worse?"

"My kidneys started shutting down."

"Why?"

I shrugged and looked at her. "You're the doctor."

She wrote that down. "So you were unable to walk in Hawaii because of the pain, but you can walk now."

"Amazing, isn't it? Must have been the fresh American air."

"Hawaii is part of America."

"Oh."

Savannah wrote something down. I tried to look over her shoulder but she shut her notebook. "Where did your leg hurt?"

"Quadriceps," I said. She pressed the muscle belly, as though feeling the muscle on the wrong leg four years too late would help her diagnose me. But I wouldn't fail her just because she couldn't diagnose me correctly. None of my doctors had.

********

After clinic duties were over, I did the proper thing and went to see hospital patients even though I didn't have to. I stood in the back of the room while Savannah discussed treatment with the patients and only stepped in when she needed help (which was never). Patient rapport wasn't one of my talents.

Savannah seemed to be glowing as she put on an isolation gown and gloves to go see Mr. Spence.

"Are you planning to make out with him?" I said, gesturing for her to hurry up. "Just go in."

Savannah ignored me and turned so I could tie the gown in the back, which I did grudgingly. "Are you coming in, Dr. H?"

"No." I let out a deep sigh and pressed my hand against my abdominal area. Savannah raised her eyebrows. "I'm fine," I said, waving her in. "Go cozy up to Mr. Spence."

She went in and I leaned back against the bar, breathing as though I'd just run a marathon. Dr. Wilson was after me to give up Vicodin, claiming it caused difficulty urinating. I hadn't read the fine print (okay, actually I had) but I was pretty sure that wasn't a side effect. I had been trying to cut back, though, ever since I saw that messed up son of Ozzy Osbourne on a True Hollywood Story talking about how his brain was screwed up from OD'ing on Vicodin.

Savannah tapped on the glass. I looked up and saw Mr. Spence trying to talk to me through the glass. I sighed. I took a breath of fresh air before I stuck my head into what I imagined to be strains of C-diff swimming through the air, even though I knew it wasn't airborne.

"Did you watch Lost last night?" Mr. Spence asked in a quavery voice.

"I did," I said, staring past Savannah as though she wouldn't listen if I didn't look at her.

"They always leave us on a cliff hanger, don't they?"

I nodded. "Brilliant show. Is that all, then?"

Mr. Spence looked confused. I didn't blame him, but I also never claimed to be a relationship genius, either. I nodded curtly and said to Savannah, "I'll be emptying my bladder if you need me."

Then I went to steal a catheter from the supply closet, found an empty hospital room, and shut myself in the bathroom.

I thought it would be easier than it was. I'd always told whining patients, "It doesn't hurt that bad!" without ever experiencing it for myself. Sweating and cussing, I wrestled with the tube, feeling sorry for my patients that I thought lubricant was a wasteful expense.

Someone knocked on the bathroom door and I jumped."Who is it?"

"Your student," Savannah said. "A nurse said you came in here. What are you doing?"

"Huffing germicide," I said. "Go away."  
"Seriously?"  
"Yes."

Savannah opened the door and gaped at me. "Thanks for lying to me. Do you need help?"

I stared down at the catheter bag. "Clearly you're either a) clueless about all things medical or b) you want to be in here because you think I'm sexy. On second thought, let's go with 'b', call a nurse, and we can make this a threesome."

"On second thought, I'll leave and you have fun," Savannah said.

"Then go," I said, shooing her away. "This is the point where it becomes humiliating and awkward. Go get lunch."

She scurried out. I returned to my office a little while later. Savannah was eating lunch when I came in. She handed me a burrito and I flipped the light off and switched on the TV.

I tucked a pillow against my stomach and leaned back in my tan recliner. Savannah sat cross legged on my couch with a lap full of my old charts and she flipped through them as we watched the show.

"I think you need to work on your charting skills," Savannah said as I muted the TV for the commercial break."You said this patient is a male and a female."

"Maybe it's a tranny," I said.

"It's a two year old!" Savannah said. She flipped through the pages and read aloud, "'The female patient is a 2 y.o. male who presents with a hairline fx of the ulna. Pt is an obnoxious ba—Dr. H! You can't write words like that!"  
Licking my fingers, I pulled the chart closer and squinted at it. "Well that answers your question of the child's gender. If it was a girl I would have said the other 'b' word."

"And I like how you have to shorten the word 'fracture' but you can write out 'obnoxious'."

"If there was an approved medical abbreviation for 'obnoxious', I would use it."

"You can't make a personal judgment like that, can you?"

I shrugged and unmuted the TV so I could watch a Burger King commercial instead of listening to Savannah lecture me. I bit into my burrito, wishing it was a burger. Man, that subliminal advertising worked!

Savannah lost interest in staring at me and began to read the charts again. "Pt presents with subarachnoid h-ge--"

"Hemorrhage," we both said at the same time. I looked at her in surprise.

"Hey, just because I'm old doesn't mean I'm stupid," Savannah said. "I can figure out abbreviations."

She laid the chart in her lap and took a bite of her burrito. "My son used to have a doctor who was bossy and obnoxious but he was great at what he did. I liked him."

"Did you make out with him in the exam room?" I asked.

"I was married then."

I tore open a package of M&Ms. "Doesn't mean you can't fantasize about your doctor."

Savannah took another bite.

"Is your silence saying you did?"

"My silence is saying you ask weird questions."

"That's not an answer. You're distracting me by insulting me. That's something I would do." I muted the TV. Suddenly real life had become more interesting than the soap. "You slept with your son's doctor!" I gasped.

"I did not!" Savannah said, her face red. She crossed her hands over the chart in her lap, her green eyes blazing.

"You didn't when you were married or you didn't at all?"  
"I didn't at all!" Savannah said.

I tossed the package of M&Ms to her to encourage her to keep talking. "But you thought about it."

"I stayed with my husband until my son was eight," Savannah said. "My son was a big bully to kids at school, and when he started to hit and yell at me, I left my husband."

I stared at her, unsure of what to say.

Savannah crunched down on a handful of M&Ms. "I couldn't bear to imagine my son growing up to be like his dad. The pediatrician was more of a...okay, I did...uh...think about dating him. But he was too much like my ex-husband, so I ditched him, too, and found a new doctor."

"Who?"

"Dr. Hussein."

"Ah, the bleeding heart." I reached over and held out my hand. Savannah poured some M&Ms into my hand.

"Your soap opera's back on," she said. "Or we could go see patients, if that interests you."

I tossed the M&Ms into my mouth to hide my smile.


	3. Chapter 3

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Cuddy handed me a file as soon as I walked in on Monday.

"I can't," I said, handing it back and heading to the elevators. "I have a class I'm responsible for."

She dropped her arm. I could tell she was weighing her options. Normally making her feel guilty worked well.

"And after that, I'm taking my student to witness the wonders of the clinic," I said, hitting the elevator button. I swear I heard her take a breath across the hall.

"Okay," she said. Her heels clicked against the floor. "You win. Teach your class and you can take this case." She gave me a pitying look as she handed me the file.

I waited until I was in the elevator to dance in celebration.

All the students were already in class, including Dr. Wilson's nerdy little student, Jack. Jack and Jimmy were already bestest friends and I heard from Cameron that they even hung out together after work. I made a face at him and he looked confused.

I stalked to the front of the room and slammed the file down on the desk. "An old lady collapsed in the fruit aisle at Walmart. Why?"

"Heart attack?" a student in the back row called out.

"Stroke!" another student offered.

I stretched my hands over my head and yawned. "Okay. Twenty three year old female collapsed at a party. Ideas?"

"Drunk," two or three students said at once.

"And...?" I stepped toward a young woman in the front row. She sat up straighter.

"Um...maybe she passed out from dehydration?"

I sighed. "And if you hadn't been so judgmental, you would find out that the twenty-three year old wasn't drinking. But the old lady at Walmart was stoned."

"Really?" Dr. Wilson's student said.

"No!" I rubbed my temples. "People don't snort cocaine at Walmart. The old lady doesn't exist. The twenty-three year old does, though. Her name is..." I squinted at the chart. "Erin...House."

Grabbing the edge of the whiteboard with my cane, I dragged it closer to the desk, sat on the edge of the desk and wrote, "Blurry/double vision. Seizures. Aphonia."

I turned back to the class. "Her friends said when she showed up at the party, she acted drunk. She had a seizure, despite being on seizure medication. When she came to, she was unable to speak."

The students did most of the diagnostic work for me so that when Savannah and I came upstairs an hour later for the team conference, I threw open the door and said, "Go do your jobs."

"For who?" Cameron said. They were all relaxed around the table, chatting, laughing, drinking coffee.

"Erin Denham," I said, tossing the file onto the table where it skidded across, sending papers fluttering. Cameron picked it up.

"Erin House?" Savannah said quietly to me as my colleagues looked through the chart.

I shrugged. "I can't go around violating HIPAA."

Savannah shoved me gently. "Go on with your bad self. You wouldn't know a HIPAA from a hippo."

I bit my lip to hide a smile.

"Sounds like a stroke," Foreman said.

"Good. That's what my students decided, too." I gestured for Savannah to have a seat at the table as I explained the symptoms to my team, writing them on the board. "What else?"

"Alcohol poisoning," Cameron said.

I looked up at the ceiling, considering. "Okay...but that doesn't explain the aphonia. Check for it anyway. Start with a blood test and check for muscle weakness."

There was a flurry of movement as the team gathered their things and left. I crossed my arms, smiling as I watched them go.

"Are we going to go?" Savannah asked.

"And do what?"

"See the patient," Savannah said.

"Well she can't talk, so what will she tell us?" I said. "If she had a stroke, she probably won't be able to write. Is she going to send drool signals? Blink once for yes and twice for no?"

Savannah sighed and crossed her arms. "Why are you a doctor?"

"Because it was better than driving a trash truck."

"Seriously."

I pulled out a chair and sat down, propping my leg up on the table. "Because everyone reacts the same to a crisis. When little Johnnie's leg gets lopped off with a hacksaw, they don't trust Allah or themselves or whatever god they believe in. They trust doctors."

"And that makes you god?"

"It makes me someone they can trust," I said. "And when Johnnie walks out of the hospital, it's me they'll remember."

"That's a lot of pressure," Savannah said, sitting down on a stool. "Haven't you ever lost someone?"

"'Lost' would imply I didn't even try," I said. "I've killed a few patients trying to save them, but I've never lost anyone."

"So I assume you're not going to give me words of wisdom on how to deal with death as a doctor?" Savannah said.

I stood and flipped the whiteboard over to the blank side and drew a line down the middle. On one side I wrote "House" and the other side I wrote "Vine."

"Okay, Joe House is dead. What do you tell his family?"

"I'm sorry, there was nothing we could do," Savannah said softly, touching me on the shoulder. "Joe passed away from a raging viral infection. He wasn't in pain when he died."

"Wrong!" I drew an 'X' on Savannah's side. "You shouldn't touch them or they'll hit you. You shouldn't tell them there was nothing you could do."

"Then what should I say?"

I leaned back. "Joe died. We gave him morphine. He wasn't in pain."

"That's it?"

I shrugged.

"You stole my line."

"It was good. I liked it." I wrote a slash mark under my own name. "Okay, you just discovered that Anne House has mad cow disease and it's incurable. How do you tell her?"

Savannah leaned back in her chair. "I'd say, 'Anne, I'm so sorry. You have mad cow disease. There's nothing we can do. We'll try to make you more comfortable so you won't be in pain'."

"And then I would walk in and say, 'Dr. Vine may be giving up on you with a few nice platitudes, but I'm going to see if we can cure you'."

"You just said it's incurable!" Savannah protested.

I held my arms out, warding her off. "We don't know that."

"Yes you do!"

I shrugged and made an 'X' on her side and a slash mark on my side.

"What would you have said?"

"Anne, you're going to die. There's nothing we can do. I'd skip all the meaningless 'I'm sorry's' and 'make you comfortable's' that don't mean anything. How are we going to make a patient more comfortable if they have a disease that's eating their brain? Give them happy cow shots?"

Savannah crossed her arms and gave me a look of death. "This game is rigged. You certainly know how to put the 'die' in 'diagnostic.'"

"No, I just put the 'agnostic' in 'diagnostic'," I said. "If someone's about to die, that's a fact. It's true. We can't change that with hope and good tidings."

My pager beeped and I headed toward the door without looking at it.

"What's going on?" Savannah asked.

"Our patient is having another seizure," I said, knowing I was right. We rushed to the room to see Erin flailing on the bed as Chase kept her from falling off the bed. Cameron had her back to me, preparing an injection.

I crossed my arms and looked at Savannah. "What do we do?"

"Uh..." Savannah's eyes widened. "Inject diazepam."

"Not quite yet," I said, stepping toward the patient. "Everyone wants to skip steps and be the hero." I took Erin's hand and squeezed it. "Hey! Wake up!"

"House!" Cameron said in a shocked tone.

"Wake up..." I looked at the patient's bracelet. "...Erin!"

The flailing stopped. Erin groaned and slowly her eyes focused on me. She looked terrified.

"Hi," I said. "I'm Dr. House. "What's your name?"

There was a long pause. Erin continued to blink at me, still looking freaked out. She stared down at my hand holding hers.

"Come on, I just gave you a clue."

"Dr. H." Savannah stepped forward. "She can't speak."

"Hold my other hand." I reached out for her right hand and she squeezed it.

"I was hoping for a nice simple stroke," I sighed. "Muscle grade's normal. Can you tell me your name?" I picked up a small dry erase board off the bedside table and tossed it onto her stomach. "You do write, don't you?"  
Without letting go of my hand (my hand was starting to lose circulation), she wrote "Erin Denham," in shaky letters.

"There are four doctors in here," I said. "Any of you can take over at any time. Oh!" I took Savannah's arm and pulled her closer to the bed. "This is my student, Dr. Vine. She'll be your doctor. Along with me, of course. I wouldn't let her come see you alone because that would be unethical."

"How long have you been on the Carbatrol for seizures?" Savannah asked.

Erin wrote, "A month."

I looked closer at her skin. "And the really bad tan was because..." I said. Erin shook her head, looking confused. I turned to my colleagues and said, "Check the liver, too. She has jaundice."


End file.
